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Study Explains Blood Donation Motivations

What keeps donors coming back?


Assumption: People donate blood in exchange for bonuses or financial rewards.

In fact: Donors who give blood regularly are motivated by the importance of their contribution to saving lives.

More Details

An international team of researchers from the HSE International Laboratory of Positive Psychology of Personality and Motivation, the Russian National Research Centre for Hematology, and a number of American universities examined the motivations of regular blood donors. More than 500 Russian and American respondents were surveyed about their motivations and emotions regarding blood donation and their intention to continue donating blood. The researchers have found that regular donors are driven by autonomous identified motivations such as helping save lives, rather than by external rewards such as bonuses or social approval. This is true for both Russians and Americans. The study findings are published in the Journal of Community & Applied Social Psychology.

What Is It All About?

There is a sizeable body of research going back to the 1970s examining the motivations for donating blood. For some donors, the motivation is merely financial. For example, in the United States, there is a blood plasma industry, which pays healthy people for their blood. 'Unfortunately, most community blood banks do not have funding to buy blood, and instead must rely on voluntary contributions,' explain study authors Kennon M. Sheldon, Evgeny Osin, Samantha Lapka, Elena Rasskazova, Liudmila Titova, Sergey Khrushev, Dmitry Vybornykh, and Tatiana Gaponova.

So, what motivates unpaid volunteerism? Empirical research has revealed many different reasons why people may engage in altruistic activity for the benefit of others or society. Some donors may recognise that donation is a public good that can only be maintained if people are willing to contribute. They feel they ‘ought’ to contribute in order to be good and responsible citizens.

Other donors might give because they want blood to be available for themselves or their loved ones when they need it. Yet others donate because they feel pressured by leaders or by groups to which they belong — they are conforming to social demands.

Many theoretical explanations of people's decision to donate can be found in academic literature. These include the theory of planned behaviour, expectancy-value theory, or self-efficacy theory. A few studies have used theories of altruistic motivation to account for donors' seeming selflessness. A number of papers have examined the effects of different kinds of financial incentives on peoples' willingness to donate.

Although these studies have provided much useful information on donation motivations, almost none of them (with one exception) refer to self-determination theory (SDT), which is used in the current study.

SDT is built on the concept of intrinsic motivation. A person is intrinsically motivated when they do something which is its own reward, such as a job one loves, a hobby, going out with friends, etc. STD also explains another type of autonomous motivation: identified motivation that is present when an action is important, meaningful and valuable to a person — something they can identify with. This meaningful action does not need to be enjoyable, eg the physical process of donating blood. The concept of identified motivation is important, as Sheldon points out, because it helps explain how a person can voluntarily do something they do not enjoy doing.

In addition to the above, SDT distinguishes between two prominent forms of ‘controlled’ (ie, non-autonomous) motivation: external and introjected (internal). The former describes a situation when a person does something primarily because it provides some tangible external reward or helps prevent disapproval or condemnation from others. Giving blood because one is pressured by a group is an example of external motivation. The second form is introjected motivation, when a person does something to avoid self-recrimination or to feel better about themselves.

In the current study, the researchers assessed how different motivations can predict continued donation intentions. The first hypothesis was that people with stronger autonomous motivations would report higher future donation intentions.

The second hypothesis was that self-determined motivations would be associated with higher positive emotions in the blood donation context, since the act of donating blood might be emotionally rewarding for them. The third hypothesis concerned the effect of positive emotions on donation intentions.

How Was It Studied?

The study sample included 521 adults with a mean age of 27.14, all of whom were surveyed via paper and pencil while waiting to have their blood drawn. There were two subsamples, one from Russia (279 respondents) and one from the Unites States (242 respondents).

There were some differences in the contexts from which the two samples were taken. The US participants were mostly college students, along with a few faculty, staff, and local community members. The survey was administered by one of the study authors, Samantha Lapka, during a three-day ‘homecoming blood drive’, held in late 2019 at a large university in the US Midwest. The majority of donors (179 out of 242) reported that this was their first donation, or that they donated once a year or less. Participants received no compensation for their contribution beyond a free meal after donating.

The Russian participants were visitors to a 24-hour blood transfusion station in Moscow. The data was collected over a two-month period (May–June 2019). Most participants were regular donors who reported donating more than five times a year (69.2%) or 2–4 times a year (33.24%). In Russia, the authors note, donors are offered minor incentives, such as free food and two days of paid time off from work for every blood donation, as well as social recognition such as the ‘Honorary Donor’ title and additional bonuses for those who have donated more than 40 times.

What Was Found?

All of the above hypotheses were confirmed by the study. Autonomous donation motivations predicted future donation intentions and were found to be a stronger predictor for US respondents. Findings from the regression analysis evidenced a stronger positive effect of intrinsic motivation and a stronger negative effect of external controlled motivation on repeat intentions in the US sample.

The positive effect of identified motivation emerged as equally strong and statistically significant in both samples. Controlled motivation did not show a positive association with future donation intentions for either Russian or US respondents.

An association between autonomous motivations and positive emotions was also confirmed. There were differences between the two subsamples concerning the association between controlled motivations and emotions. Controlled introjected motivations, eg when one donates to avoid a feeling of guilt, was associated with positive emotions in the Russian sample but not in the US sample.

Positive emotions in the blood donation context made one more likely to continue donating in the future.

According to the authors, certain differences between the US and Russian samples may be due to cultural variations, eg in value orientations. Future research might further explore these cultural variations. The authors also note the obvious differences between the sampling contexts: a blood donation drive in the US and a round-the-clock blood transfusion station in Russia, and the fact that the Russian sample mainly consisted of habitual donors, in contrast to the US sample. Another contextual aspect is that in the United States, nearly 8 million individuals, or 2.4% of the population, donate blood each year, compared to Russia, where the corresponding number is 1.3 million, or 0.9% of the population.

However, despite the sampling context and cultural differences, the study confirms an overall positive effect of identified motivation on future donation intentions. A person who feels motivated to donate regardless of external rewards, social pressure or guilty feelings is more likely to give blood again in the future.

Why Should We Care?

Situations where patients urgently need blood transfusions are common worldwide. Therefore, blood banks must be continuously restocked, according to Evgeny Osin, Deputy Head of the HSE International Laboratory of Positive Psychology of Personality and Motivation and co-author of the study.

Most blood supply systems rely on the benevolence of donors who give blood in advance of need. It is therefore essential to know what motivates people to become regular donors. The COVID-19 crisis has exacerbated the problem, with escalating numbers of patients needing blood, and social distancing making it difficult for agencies to run public blood drives as they have in the past.

Study authors:

Kennon Sheldon, Academic Supervisor, International Laboratory of Positive Psychology of Personality and Motivation, HSE University; Professor, Department of Psychology, University of Missouri, USA

Evgeny Osin, Deputy Head, International Laboratory of Positive Psychology of Personality and Motivation, HSE University

Samantha Lapka, Purdue University, Indiana, USA

Elena Rasskazova, Leading Research Fellow, International Laboratory of Positive Psychology of Personality and Motivation, HSE University

Liudmila Titova, University of Washington, Seattle, Washington, USA

Sergey Khrushev, National Research Centre for Hematology, Moscow, Russia

Dmitry Vybornykh, National Research Centre for Hematology, Moscow, Russia

Tatiana Gaponova, National Research Centre for Hematology, Moscow, Russia 

Author: Marina Selina, October 27, 2022